Utilization of the Medical Research Council Evaluation Framework in the Development of Technology for Symptom Management

Abstract

Technology is becoming an important medium for supporting patients in health care. However, successful application depends on user acceptability. The Advanced Symptom Management System (ASyMS) involves patients reporting cancer chemotherapy-related symptoms using mobile phone technology. The aim of this article was to report a study of how young people were involved in the development of ASyMS using the Medical Research Council framework for evaluating complex interventions. A convenience sample of young people aged 13 to 18 years undergoing cancer chemotherapy were recruited from 2 principal cancer treatment centers in London. In phase 1, young people selected 5 symptoms from an adapted version of the Memorial Symptom Assessment Scale that were most important to them. In phase 2, young people completed the ASyMS-YG PDA (personal digital assistant) questionnaire daily on days 1 to 14 of a cycle of chemotherapy and pre/post-use questionnaires. In phase 1, 5 young people chose diarrhea, nausea, vomiting, constipation, and weight loss as the most important symptoms. In phase 2, 25 young people reported positively to using PDA technology, found ASyMS-YG simple and easy to complete, and liked that they were monitored at home. In addition to the 5 core symptoms, the ASyMS-YG reports showed the number (n = 37) of other symptoms young people experienced. This early development work indicates the acceptability of ASyMS-YG and has informed an exploratory trial (phase 3) and randomized controlled trial (stage 4). This study reaffirms the importance of promoting communication between young people and health professionals.